do you believe in magic the sense and nonsense of alternative medicine

In Do You Believe in Magic?, medical expert Paul A. Offit, M.D., offers a scathing exposé of the alternative medicine industry, revealing how even though some popular therapies are remarkably helpful due to the placebo response, many of them are ineffective, expensive, and even deadly.Dr. Offit reveals how alternative medicine—an unregulated industry under no legal obligation to prove its claims or admit its risks—can actually be harmful to our health.Using dramatic reallife stories, Offit separates the sense from the nonsense, showing why any therapy—alternative or traditional—should be scrutinized. He also shows how some nontraditional methods can do a great deal of good, in some cases exceeding therapies offered by conventional practitioners.An outspoken advocate for sciencebased health advocacy who is not afraid to take on media celebrities who promote alternative practices, Dr. Offit advises, “There’s no such thing as alternative medicine. There’s only medicine that works and medicine that doesn’t.”

To all the science writers, science advocates, and science bloggers who have dared proclaim that the emperors of pseudoscience have no clothes

When religion was strong and science weak,

men mistook magic for medicine.

Now, when science is strong and religion weak,

men mistake medicine for magic.

—THOMAS SZASZ

Dedication

Epigraph

Prologue: Taking a Look at Alternative Medicine

Introduction: Saving Joey Hofbauer

Part I: Distrust of Modern Medicine

1 Rediscovering the Past: Mehmet Oz and His Superstars

Part II: The Lure of All Things Natural

2 The Vitamin Craze: Linus Pauling’s Ironic Legacy

Part III: Little Supplement Makers Versus Big Pharma

3 The Supplement Industry Gets a Free Pass: Neutering the FDA

4 Fifty-One Thousand New Supplements: Which Ones Work?

Part IV: When the Stars Shine on Alternative Medicine

5 Menopause and Aging: Suzanne Somers Weighs In

6 Autism’s Pied Piper: Jenny McCarthy’s Crusade

7 Chronic Lyme Disease: The Blumenthal Affair

Part V: The Hope Business

8 Curing Cancer: Steve Jobs, Shark Cartilage, Coffee Enemas, and More

9 Sick Children, Desperate Parents: Stanislaw Burzynski’s Urine Cure

Part VI: Charismatic Healers Are Hard to Resist

10 Magic Potions in the Twenty-First Century: Rashid Buttar and the Lure of Personality

Part VII: Why Some Alternative Therapies Really Do Work

11 The Remarkably Powerful, Highly Underrated Placebo Response

12 When Alternative Medicine Becomes Quackery

Epilogue: Albert Schweitzer and the Witch Doctor: A Parable

Acknowledgments

Notes

Selected Bibliography

Index

About the Author

Also by Paul A Offit, M.D.

Credits

Copyright

About the Publisher

Taking a Look at Alternative Medicine

Americans love alternative medicine They go to their acupuncturist or chiropractor or naturopath torelieve pain They take ginkgo for memory or homeopathic remedies for the flu or megavitamins forenergy or Chinese herbs for potency or Indian spices to boost their immune systems Fifty percent ofAmericans use some form of alternative medicine; 10 percent use it on their children It’s a $34-billion-a-year business My friends are no different One uses cold laser therapy for his allergies,another takes a homeopathic remedy named oscillococcinum to cure her colds, and a third swears thatacupuncture is the only thing that relieves his back pain

Furthermore, alternative medicine—which in the 1960s was denigrated as fringe or unconventionalmedicine—has entered the mainstream Hospitals have dietary supplements on their formularies oroffer Reiki masters to cancer patients or teach medical students how to manipulate healing energies

In 2010, a survey of six thousand hospitals found that 42 percent offered some form of alternativetherapies When asked why, almost all responded, “patient demand.” Big Pharma is also jumping in

On February 27, 2012, Pfizer acquired Alacer Corporation, one of the country’s largest manufacturers

of megavitamins

The reason alternative therapies are popular is simple Mainstream doctors are perceived asuncaring and dictatorial, offering unnatural remedies with intolerable side effects Alternativehealers, on the other hand, provide natural remedies instead of artificial ones, comfort instead ofdistance, and individual attention instead of take-a-number-and-wait-your-turn inattention

Like many people who have spent time in today’s health-care system, my experiences have beenlargely disappointing

I was born with clubfeet Within hours, both feet were put in casts; the left foot healed; the rightdidn’t When I was five years old, a surgical procedure was performed on my right foot; one of thefirst of its kind, my case was later written up in a medical journal The good news is that my right foot

no longer turns awkwardly down and inward The bad news is that walking is always somewhatpainful for me

While in medical school, I volunteered for a twenty-five-mile walkathon for the National MultipleSclerosis Society After completing the walk, the pain in my foot was so bad I had to use crutches for

a few days I visited an orthopedist, who told me I had severe osteoarthritis and that my X-ray lookedlike that of a seventy-year-old man I was twenty-four For most of my adult life, I’ve tried

conventional nonnarcotic pain medicines without relief.

When I was in my thirties, I noticed a small dark spot—no bigger than the head of a pin—on thefront of my nose I ignored it Twelve years later, my wife suggested I have it removed Theprocedure was fast and painless But a few days later, the dermatologist called with some bad news

He had received a report from the pathologist The diagnosis: metastatic malignant melanoma Adeath sentence

I panicked and immediately called the pathologist “This diagnosis doesn’t make any sense,” Ipleaded “How could I have a metastatic lesion on only one part of my body that has remainedunchanged for more than a decade? And where’s the primary cancer, the place from which themetastasis had supposedly spread? Doesn’t this make me the longest-living survivor of untreatedmetastatic melanoma in history?!” The pathologist was sympathetic but unfazed The diagnosis waswhat it was If I wanted her to, however, she was willing to send my biopsy to the nation’s foremostexpert on melanoma: a dermatopathologist in New York City A few weeks later, he called with hisdiagnosis: metastatic malignant melanoma He patiently explained that, given where the malignantcells were and what they looked like, it couldn’t be anything else

For the next two years, I went to the dermatology clinic at the University of Pennsylvania, gettingperiodic physical examinations, chest X-rays, and blood tests looking for evidence of furthermetastases None were found Also, no one could find the original site from which my melanoma hadsupposedly spread A mystery, they claimed

Later, my wife, who is also a doctor, sent my biopsy to a dermatologist friend of hers, who saidthat I didn’t have malignant melanoma—my real diagnosis was cutaneous blue nevus syndrome, abenign disorder that mimics melanoma I was happy to be done with it But two years of thinking that Iwas suffering from a fatal illness had been hell

When I was in my early fifties, a sharp, persistent pain in my left knee made it difficult to walk.Unable to tolerate it any longer, I visited an orthopedist, who diagnosed a partially torn medialmeniscus (the cartilage in the knee that keeps bone from rubbing against bone) The surgery will besimple, he explained, with a full recovery in a few days But in the postoperative haze of anesthesia, Ilearned that it hadn’t been that easy The orthopedist explained that my problem wasn’t a tornmeniscus after all; it was a loss of cartilage behind my kneecap Instead of minor knee surgery, I hadjust undergone microfracture surgery, where small holes are drilled into bone The recovery wasn’tgoing to be a few days—it was going to be a year The miscalculation didn’t seem to surprise orupset the orthopedist But it upset me

By my mid-fifties, consistent with my age, I began to suffer symptoms of an enlarged prostate Now

I was in the world of urologists, which meant I would periodically get my PSA level checked PSA,

or prostate-specific antigen, is supposedly a predictor of prostate cancer But the more I read studiesabout PSA, the more I realized it isn’t a very good predictor at all Even biopsies of the prostate are

confusing As it turns out, most men with prostate cancer die with the cancer, not from it Which

means that most men with prostate cancer have needless surgery And the surgery is brutal, leavingmany incontinent and impotent As a consequence, urologists have varying opinions about how toavoid prostate cancer

During these misadventures, I’ve gotten a lot of advice from a lot of people Some have gone as far

as to suggest I abandon conventional medicine They said I should take saw palmetto for my prostateand chondroitin sulfate and glucosamine for my foot and knee pain—all readily available without aprescription They told me that I shouldn’t have seen an orthopedist—I should have seen anacupuncturist or a chiropractor—and that I shouldn’t have gone to a urologist for prescription drugs: I

should have gone to a naturopath for something more organic, more natural They urged me to stopbeing so trusting of modern medicine and to once and for all take control of my health—to leave asystem that was clearly flawed.

So I went to the General Nutrition Center and bought saw palmetto, chondroitin sulfate, andglucosamine But before I took them, I looked to see whether studies had been done showing theyworked The studies were large, internally consistent, well controlled, and rigorously performed.And the results were clear: saw palmetto didn’t shrink prostates, and chondroitin sulfate andglucosamine didn’t treat joint pain Then I reviewed studies of acupuncture, naturopathy, homeopathy,and megavitamins, which also showed results far less amazing than my friends had led me to expect

Some therapies worked; most didn’t And for those that did work, it was how they worked that was

surprising

Perhaps most concerning, I found that alternative therapies could be quite harmful Chiropracticmanipulations have torn arteries, causing permanent paralysis; acupuncture needles have causedserious viral infections or ended up in lungs, livers, or hearts; dietary supplements have causedbleeding, psychosis, liver dysfunction, heart arrhythmias, seizures, and brain swelling; and some

megavitamins have been found to actually increase the risk of cancer My experience wasn’t limited

to reading medical journals As head of the therapeutic standards committee at our hospital, I learned

of one child who suffered severe pancreatitis after taking more than ninety different dietarysupplements and another whose parents insisted on using an alternative cancer cure made from humanurine

What I learned in all of this was that, although conventional therapies can be disappointing,alternative therapies shouldn’t be given a free pass I learned that all therapies should be held to thesame high standard of proof; otherwise we’ll continue to be hoodwinked by healers who ask us tobelieve in them rather than in the science that fails to support their claims And it’ll happen whenwe’re most vulnerable, most willing to spend whatever it takes for the promise of a cure

The purpose of this book is to take a critical look at the field of alternative medicine—to separatefact from myth Because the truth is, there’s no such thing as conventional or alternative orcomplementary or integrative or holistic medicine There’s only medicine that works and medicinethat doesn’t And the best way to sort it out is by carefully evaluating scientific studies—not byvisiting Internet chat rooms, reading magazine articles, or talking to friends

Saving Joey Hofbauer

They were small

And could not hope for help and no help came.

—W H Auden, “The Shield of Achilles”

My first exposure to alternative medicine came by way of a story that circulated during mypediatric residency in the late 1970s It involved a popular alternative cancer remedy called laetrile.Some might read what follows and feel assured it could never happen today—that no parent wouldever do such a thing But every single influence that drove these parents to do what they did is stillvery much alive, arguably even more so than it was then

The story concerns a little boy from upstate New York

On October 5, 1977, Joey Hofbauer complained to his mother about a lump on his neck When thelump didn’t go away, she took him to their family doctor, Denis Chagnon, who prescribed penicillin,without effect When the lump got bigger, Chagnon referred Joey to an ear, nose, and throat specialist,

Dr Arthur Cohn, who, on October 25, biopsied it at St Peter’s Hospital, in Albany Two days later,Cohn had his diagnosis: Hodgkin’s disease, a cancer of the lymph glands Joey was seven years old

Although the news was devastating, Joey’s prognosis was excellent By the early 1970s,investigators had proved that radiation and chemotherapy offered Joey a 95 percent chance ofrecovery—with proper treatment, Joey could live a long and fruitful life But for Joey Hofbauer, theroad to recovery wasn’t going to be easy Within weeks, a battle erupted over how Joey should betreated and by whom On one side were Joey’s parents, citizen activists, the media, the John BirchSociety, and a movie star On the other were cancer specialists, Senator Edward Kennedy, theSaratoga County Department of Social Services, and the Food and Drug Administration (FDA) Thebattle lasted three years

When he learned that Joey had Hodgkin’s disease, Arthur Cohn advised the Hofbauers to see a

cancer specialist The specialist would determine the extent of Joey’s cancer by taking biopsies of theliver and spleen Then Joey would receive radiation and chemotherapy—medicines likeprocarbazine, prednisone, vincristine, and nitrogen mustard Cohn reassured the Hofbauers that theirson had an excellent chance of survival But John and Mary Hofbauer weren’t reassured They heard

words like radiation and chemotherapy, and it scared them, conjuring up images of hair loss,

vomiting, diarrhea, anemia, and worse Certainly there was a better way to treat their son—a morenatural way So they rejected Cohn’s advice and signed Joey out of St Peter’s Hospital OnNovember 8, the Hofbauers flew their son to the Fairfield Medical Center, in Montego Bay, Jamaica,

to receive a remedy they believed was far gentler, far kinder, and far more reasonable than thoserecommended by Dr Cohn: laetrile, a natural remedy made from apricot pits

The day the Hofbauers flew to Jamaica, Denis Chagnon wrote a letter: “Dear Mr and Mrs.Hofbauer, I have repeatedly asked for the name and address of a physician to whom I can send[Joey’s] records I spoke with Mrs Hofbauer in the morning hours of Friday, November 4th, andagain on Monday, November 7th, and was not provided with an answer Without treatment[Hodgkin’s] disease is oftentimes fatal I ask you again to provide me with the name and address ofhis present physician [to] ensure that [Joey] is being properly cared for If this is not provided bynoon, Thursday, November 10th, the following action will be taken: notification of the State HealthDepartment, the Children’s Protective Agency, and the American Cancer Society.” When theHofbauers left for Jamaica, Chagnon carried out his threat, reporting them to child services OnNovember 9, the Department of Social Services of Saratoga County, New York, charged John andMary Hofbauer with neglect, seeking to remove Joey from the home The law was clear: “The State,under appropriate circumstances, may provide medical care for a minor where the parent or guardianfails to do so.”

On November 23, the Hofbauers returned from Jamaica Because written and telephonecorrespondence had been ignored, on November 29, Richard Sheridan and Diana Fenton, from theDepartment of Social Services—accompanied by an armed sheriff’s deputy—visited the Hofbauers.Sheridan remembered what happened next: “[Mr Hofbauer said] that we weren’t going to take hischild away unless the Sheriff’s deputy drew his gun and arrested him.” Sheridan told Hofbauer thatthe state of New York was now in charge of Joey’s care “I told him there was a [hearing],” recalledSheridan, “and he said it was illegal because he wasn’t there I said that this was not the place to be

talking about this, and Mr Hofbauer yelled very loudly that it was the place to be talking about this,

and he wanted everybody to know that we were coming to take his son.” Hofbauer was convincedthat cancer specialists would only harm Joey “He said I wanted to take his son and poison [him],”said Sheridan “He said ‘Do you know what chemotherapy is? It’s nitrogen mustard gas It wasdeclared illegal in the wars.’ ”

When the dust settled, the Hofbauers relented Through their lawyer, they worked out a deal Joeywould be taken to St Peter’s Hospital with an understanding that no diagnostic tests would beperformed and no treatment would be administered—at least not until the case could be heard infamily court Joey stayed at St Peter’s from November 29 to December 9 But John Hofbauercouldn’t watch silently while his son was denied what he believed was a lifesaving medicine So hesecretly gave Joey several doses of laetrile until “we were threatened with armed guards at the door,

at which time we desisted.”

In December 1977, the case of Joey Hofbauer was referred to Saratoga Family Court judge Loren

N Brown, who, much to the dismay of child services, agreed to let the Hofbauers treat their son withlaetrile for six months On one condition: they had to find a licensed physician willing to do it “I had

a situation where I had to find a doctor in a hurry,” recalled Hofbauer, “because everybody wasdemanding to know who my doctor was.” First, Hofbauer asked Dr Milton Roberts, in WestchesterCounty But Roberts worried the case had become “too hot to handle,” so he turned him down ThenHofbauer asked Michael Schachter, a psychiatrist from Nyack, New York Schachter agreed, but only

if the Hofbauers signed a consent form releasing him of all responsibility: “I agree to undergo carewith Michael B Schachter, MD,” it began “I understand [that] among the substances, medications, ordrugs available [laetrile] may be advised for the purpose of metabolic support The predominantmedical view, including that of the Food and Drug Administration (FDA) and the American MedicalAssociation (AMA) is that this substance [has] no known value [for] the treatment of any disease Iunderstand that some alleged authorities associated with the FDA and AMA assert that the use of thissubstance constitutes quackery and amounts to a hoax on the American public I further understand thatAmerican physicians have been indicted in California for the use of this substance I understand that

Dr Michael Schachter [is] not a cancer specialist and [has] no direct experience with the orthodoxcancer therapy modalities of chemotherapy, radiation or surgery [and is] not in a position to advise

me as to the relative benefits and risks of those treatments for my condition.” On December 14, Johnand Mary Hofbauer signed Michael Schachter’s consent form

Six months later, in June 1978, the court would reconvene to see whether laetrile was working and

to determine who would care for Joey Hofbauer: his parents or the state

Michael Schachter didn’t limit his therapy to laetrile For the next six months, he also gave Joeyraw milk, raw liver juice, cod liver oil, soft-boiled eggs, Staphylococcus phage lysate (staph bacteriainfected with a virus), pancreatic enzyme enemas (which partially dissolve the lining of the colon),massive doses of vitamin A (which cause blurred vision, bone pain, and dizziness), a vaccine to

prevent “Progenitor cryptocides” (a bacterium believed by a physician named Virginia Livingston

to cause all cancers), a vegetarian diet, daily coffee enemas made by adding three heapingtablespoons of regular coffee to one quart of water (coffee enemas had already caused two deaths),seven injections of an “autogenous vaccine” (made from bacteria in Joey’s urine), and Wobe-Mugosenzymes (a combination of several pancreatic enzymes obtained from pigs) None of these therapieshad been approved for use in people, and all were arguably in violation of New York State laws onhuman experimentation A cancer specialist who later testified at Joey’s trial called it “a witchdoctor’s diet.”

In June, six months into Joey’s unconventional treatments, the Saratoga County Department ofSocial Services, Dr Michael Schachter, and several cancer specialists appeared before Judge Brown

to determine whether Joey’s alternative cancer cures were working Most damning was the testimony

of John Horton, a professor of medicine at Albany Medical College and a board-certified cancerspecialist, who had recently examined Joey “On feeling the left side of the neck there was a [large]lymph node under the angle of the jaw,” he said, “and just below that another [large] lymph node[and] a string of lymph nodes coming down the neck as far as the clavicle [collarbone].” At the time

of his diagnosis, Joey Hofbauer had had one swollen lymph gland; now he had seventeen Dr.Anthony Tartaglia, a board-certified hematologist and chief of medicine at St Peter’s Hospital, hadalso examined Joey “There is no question in my mind that the extent of Hodgkin’s disease in [Joey] ismuch greater than when I examined him in December,” he said Tartaglia added that the laetrile that

Joey had received was the “equivalent of not getting any treatment.”

There were other worrisome signs Tests showed that Joey had liver damage, most likely caused

by dangerously high doses of vitamin A Also, Schachter apparently didn’t realize that Joey’s

“occasional nausea and abdominal cramps” were probably caused by cyanide poisoning from largedoses of laetrile, having never obtained blood cyanide levels to check it out

Unlike the cancer specialists who had examined Joey, Michael Schachter believed his programwas working “I think he is doing very, very well,” he said “I’m just not as concerned about theselymph nodes in the neck as the other physicians I feel that [laetrile and metabolic therapy] will beplaying a major role in the way medicine is practiced over the next five to ten to fifteen years andconsequently I would say that his treatment has been more than adequate, it has been superior.” TheHofbauers brought in their own experts—specifically, laetrile promoter Hans Hoefer-Janker;laetrile’s inventor, Ernest Krebs Jr.; and Marco Brown, who ran the Fairfield Medical Center, inJamaica On July 5, Judge Brown ruled in favor of the parents, stating that they were “concerned andloving” and that Dr Schachter was “duly licensed.”

Although the cancer had spread into his neck, Joey was in the early stages of Hodgkin’s disease.And the Saratoga Department of Social Services wasn’t giving up There was still time.Unfortunately, public sentiment was turning in favor of laetrile, making it harder and harder for Joey

to get the medicines he needed to save his life

By the end of the 1970s, laetrile wasn’t just a drug; it was a social movement

Led by Robert Bradford, of Los Altos, California, the John Birch Society—an ultraconservativeorganization dedicated to eliminating government regulations—founded the Committee for Freedom

of Choice in Cancer Therapy By 1977 the committee claimed five hundred chapters and thirty-five

thousand members Committee members influenced popular television programs like 60 Minutes, magazines like Newsweek, and commentators like James Kilpatrick, all of whom promoted the

wonders of laetrile Almost singlehandedly, they successfully rallied public support for the drug In

1976, Alaska became the first state to legalize both the manufacture and sale of laetrile; by 1978fourteen states had followed; by 1979, twenty-one Most Americans favored the legalization oflaetrile; by 1980 it was a billion-dollar-a-year industry A movement had been born—a movementthat would soon include one of the most popular movie stars of the day

In the summer of 1978, Steve McQueen (The Great Escape, The Thomas Crown Affair, Bullitt, The

Towering Inferno ) suffered from a persistent cough and weight loss Doctors diagnosed him with

bronchitis, then walking pneumonia, then a fungal infection Eventually a lung biopsy revealed theproblem: mesothelioma, an aggressive type of lung cancer After learning he had cancer, McQueenchecked into Cedars-Sinai in Los Angeles to begin radiation and chemotherapy, which didn’t work.Doctors told him he had only two months to live So McQueen took matters into his own hands,choosing to treat himself with laetrile at a clinic in Mexico run by William D Kelley

Kelley was a flamboyant, charismatic promoter of alternative therapies Born in Arkansas City,Kansas, he had studied dentistry at Baylor before setting up a clinic in Fort Worth and later in

Grapevine, Texas There Kelley started a mail-order vitamin business Like Michael Schachter,Kelley believed nonspecific nutritional therapies could treat cancer Under the direction of Kelley,McQueen received laetrile, massages, shampoos, megavitamins, nutritional supplements, chiropracticadjustments, a high-fiber diet, sheep embryo shots, enzyme implants, and twice-daily coffee enemas(marketed as Kelley’s Koffee)—treatments that cost McQueen ten thousand dollars a month(equivalent to eighty thousand dollars today).

Kelley used McQueen’s celebrity to promote laetrile Appearing on the national television show

Tomorrow, hosted by Tom Snyder, he said, “Those doctors gave him no hope But his chances are

excellent I believe with all my heart that this approach represents the future of cancer therapy It tookWinston Churchill”—one of the first people to be treated with antibiotics—“to popularize antibioticmedicine Steve McQueen will do the same for metabolic therapy.” McQueen echoed Kelley’senthusiasm; appearing on Mexican television, he said, “Mexico is showing the world this new way offighting cancer through nonspecific metabolic therapy Thank you for saving my life God bless youall.”

The John Birch Society’s manipulation of the media and the celebrated case of Steve McQueeninfluenced public opinion Laetrile had moved into the mainstream On December 14, 1978, theSaratoga County Department of Social Services appealed Judge Brown’s ruling of six months earlier.The case went before Judge Sweeney of New York’s Third District Court of Appeals, whoreaffirmed the earlier decision: “We are of the view that there is ample proof to support the findingsand determination of [Judge Brown’s] trial court.”

Joey Hofbauer would continue to be treated by Michael Schachter

The Saratoga County Department of Social Services still had one more appeal—one more chance tosave Joey Hofbauer’s life The decision would be made on July 10, 1979 Fortunately for JoeyHofbauer, several events had been set in motion that would soon reduce the public’s desire forlaetrile But Joey was getting sicker; the clock was ticking

On May 26, 1977, Franz Ingelfinger, the distinguished editor of the New England Journal of

Medicine, published an editorial titled “Laetrilomania.” Ingelfinger wrote, “As a cancer patient

myself, I would not take Laetrile under any circumstances If any members of my family had cancer, Iwould counsel them against it If I were still in practice, I would not recommend it to my patients.”Despite his personal feelings, Ingelfinger suggested a definitive study—one that would settle theargument once and for all In December 1979, the FDA granted an “investigational new drug” licensefor laetrile, opening the door for a study This was the first time in the history of the United States thatthe FDA had approved human testing of a cancer drug that had never been shown to work inexperimental animals

While researchers were designing Ingelfinger’s laetrile study, other events were working on Joey’sbehalf In July 1977, Senator Edward Kennedy of Massachusetts held a hearing to discuss the value oflaetrile Testifying in favor of the drug were San Francisco physician and laetrile proponent JohnRichardson, John Bircher Robert Bradford, and laetrile inventor Ernest Krebs Jr Kennedy didn’t buy

it, saying, “There isn’t a scintilla of evidence that [laetrile] provides any sense of hope in curing orpreventing cancer.” During the hearing, representative Terrence McCarthy of Massachusetts was lesspolitic “The people selling laetrile are crooks, liars, and thieves,” he said

Unfortunately, clear statements by the editor of the New England Journal of Medicine and Senator

Edward Kennedy didn’t convince the courts that Joey Hofbauer had received inadequate care OnJuly 10, 1979, in response to the Saratoga County Department of Social Services’ final appeal, JudgeJasen ruled that he was “unable to conclude, as a matter of law, that Joseph’s parents [had] notundertaken reasonable efforts to ensure that acceptable medical treatment is being provided theirchild.” It was Joey Hofbauer’s last chance to receive the radiation and chemotherapy he needed.Jasen still considered laetrile, coffee enemas, pancreatic enzymes, and a “vaccine” made frombacteria in Joey’s urine to be “acceptable medical treatment.”

On July 10, 1980, ten-year-old Joey Hofbauer died of Hodgkin’s disease, his lungs riddled withcancer Although Michael Schachter acknowledged that Hodgkin’s disease had killed Joey, heclaimed partial success “Most of the body was either free of Hodgkin’s or minimally involved,” hesaid

Four months later, America’s most celebrated standard-bearer for laetrile, Steve McQueen, alsodied After McQueen’s appearance on Mexican television, Cliff Coleman, a longtime friend, had paidhim a visit “I walked over and there was this skinny old man,” recalled Coleman “No more than askeleton with dark eyes and a matted beard, sitting swallowed up in an armchair.” McQueen toldColeman, “I can’t take it anymore.” One month later, McQueen was taken to a medical clinic in ElPaso, Texas, where tests showed that cancer had spread from his lungs to his abdomen, liver, andpelvis Within a few days, on November 7, 1980, during surgery to remove a massive abdominaltumor, Steve McQueen died of a heart attack

One year after the deaths of Joey Hofbauer and Steve McQueen, cancer specialist Charles Moertel,

of the Mayo Clinic in Rochester, Minnesota, led research teams at UCLA, the University of Arizona,and the Memorial Sloan-Kettering Cancer Center, in New York, in the clinical trial proposed byFranz Ingelfinger They treated 178 cancer victims with laetrile and high doses of vitamins, findingthat the combination didn’t cure, improve, or stabilize cancers “Patients died rapidly, with a mediansurvival of only 4.8 months,” they wrote “It must be concluded that Laetrile [is] of no substantivevalue in the treatment of cancers Further investigation or clinical use of such therapy is not justified.”Researchers also found that several patients had suffered symptoms of cyanide poisoning fromlaetrile Within a year of the publication, laetrile sales dropped dramatically In 1987, the FDAbanned the sale of laetrile (It can still be obtained from clinics in Mexico or illegally from theInternet In recent years, more websites have appeared promoting the drug.)

In retrospect, the last best chance to save Joey Hofbauer had occurred in one court and one courtonly: Judge Loren Brown’s family court This was the only time that cancer specialists had testified.Lawyers working on behalf of Joey had done their homework The doctors and scientists presented bythe state had published hundreds of papers, written book chapters on Hodgkin’s disease, chairedprofessional societies, headed research teams showing the value of radiation and chemotherapy,performed studies in experimental animals showing that laetrile didn’t work and was dangerous, orheaded the FDA’s section on cancer treatments They were, in short, the brightest, most accomplished

members of their field.

The doctors and scientists offered by the Hofbauers also shared several characteristics: none wereboard-certified in oncology, hematology, or toxicology; none had ever published a paper in a medicaljournal; none had shown any reasonable evidence that their therapies worked; and most didn’t evenhave hospital privileges That Brown could rule in favor of the Hofbauers’ choice to deny their son aproven, effective therapy is unconscionable But an explanation can be found in the record of the trial

In the section titled “Findings of Fact and Conclusion of Law,” Brown wrote, “This court finds thatmetabolic therapy has a place in our society, and, hopefully, its proponents are on the first rung of aladder that will rid us of all forms of cancer.” Brown believed that his small family court in SaratogaCounty had witnessed a miracle—a breakthrough that would soon turn cancer therapy on its ear ToJudge Brown, the notion that laetrile and coffee enemas could treat Joey Hofbauer wasn’t a matter ofopinion; it was a “Finding of Fact.”

There was another force working against Joey Hofbauer in Judge Brown’s courtroom that day—aforce far more powerful than clinicians like Michael Schachter or laetrile promoters like ErnestKrebs Jr or ideologues like Robert Bradford It was revealed during an exchange between theHofbauers’ lawyer, Kirkpatrick Dilling, and Victor Herbert, a cancer specialist Dilling wasquestioning Herbert about the value of bonemeal

DILLING: Calcium, is that an essential nutrient?

HERBERT: Yes.

DILLING: Are you familiar with the fact that bonemeal is very high in calcium?

HERBERT: I’m familiar with the fact that bonemeal is a dangerous quack remedy because of its lead content and people have died from being given bonemeal instead of calcium properly in milk and milk products.

DILLING: Isn’t bonemeal widely available?

HERBERT: Certainly is, your organization pushes it.

Dilling froze His organization? Herbert had revealed something that wasn’t evident to most in thecourtroom that day—exactly who was paying for the Hofbauers’ defense Recovering, Dilling went

on the offensive “I want to state for the record,” he said, “that I’m proud to represent the NationalHealth Federation and I would appreciate it if the witness would keep his views to himself.”

The National Health Federation (NHF) is an organization that represents the financial interests ofthe alternative medicine industry At the time of Joey’s trial, these therapies had become quitelucrative Kirkpatrick Dilling was general counsel to the NHF Against these powerful financialinterests, Joey Hofbauer didn’t have a chance

Michael Schachter was never held accountable for his treatment of Joey Hofbauer On the contrary,since Joey’s death Schachter has thrived, directing the Schachter Center for ComplementaryMedicine, in Suffern, New York In 2010, a promotional brochure claimed he “has successfullytreated thousands of patients using orthomolecular psychiatry, nutritional medicine, chelation therapyfor cardiovascular disease, and alternative cancer therapies.”

Joey Hofbauer’s story, while extreme, contains much of what attracts people to alternative therapies

today: a heartfelt distrust of modern medicine (John and Mary Hofbauer didn’t believe the advice ofhematologists and oncologists); the notion that large doses of vitamins mean better health (Joey wasgiven massive doses of vitamin A, which was likely to have been to his detriment); the belief thatnatural products are safer than conventional therapies (the Hofbauers preferred laetrile, pancreaticenzymes, coffee enemas, and raw liver juice to radiation and chemotherapy); the lure of healerswhose charisma masks their lack of expertise (Michael Schachter, a psychiatrist, convinced theHofbauers he could cure their son, even though he had no expertise treating cancer); the power ofcelebrity endorsements (Steve McQueen was one of the most popular movie stars of his day); and,perhaps most of all, the unseen influence of a lucrative business (Kirkpatrick Dilling’s NHF, stillactive today, is one of many lobbying groups that have influenced Congress to offer specialprotections to the fourteen hundred companies that manufacture alternative remedies in the UnitedStates).

Part I

DISTRUST OF MODERN MEDICINE

Rediscovering the Past:

Mehmet Oz and His Superstars

Oh, no, my dear; I’m really a very good man, but I’m a very bad Wizard.

—The Wizard of Oz

Few celebrities are more recognizable than Oprah Winfrey At the height of her syndicated talkshow, which attracted more than 40 million viewers a week, Oprah launched the career of a man whowould soon become America’s most recognized promoter of alternative medicine: Mehmet Oz, star

of The Dr Oz Show.

Like Winfrey’s, Oz’s show is also popular—more than 4 million people watch it every day It’snot hard to figure out why It’s the same reason that John and Mary Hofbauer were attracted toMichael Schachter, or Steve McQueen to William Kelley Oz believes that modern medicine isn’talways to be trusted—that we should retreat to an age when healing was more natural, less clutteredwith man-made technologies

On the surface, Mehmet Oz would seem to be the last person to argue against modern medicine.After graduating from Harvard University, the University of Pennsylvania School of Medicine, andthe Wharton School, Oz climbed the ranks at Columbia University Medical Center to become a fullprofessor in cardiovascular surgery He performs as many as 250 operations a year and has authored

400 medical papers and book chapters Six of his books have been on the New York Times best-seller list Oz was voted one of Time magazine’s 100 Most Influential People, the World Economic Forum’s Global Leader of Tomorrow, Harvard University’s 100 Most Influential Alumni, Esquire’s Best and Brightest, and Healthy Living’s Healer of the Millennium He’s not just famous; he’s a

brand (“America’s Doctor”)

Certainly, no one appreciates the advances of modern medicine more than Mehmet Oz He’s a heartsurgeon He holds people’s hearts in his hands and fixes them Oz couldn’t do this without anesthesia,

antibiotics, sterile technique, and heart-lung machines But there was one moment when it becameclear that Mehmet Oz wasn’t a typical heart surgeon During an operation, “Oz jumped up on astanding stool, peered into the patient’s chest, and said, ‘I knew we should have used subliminaltapes.’” Oz believed that surgery wasn’t enough—success also depended on tapping into his patient’ssubconscious Watching this scene was Jery Whitworth, a nurse who operated the heart-lung machine.Whitworth shared Oz’s love of alternative therapies “After a few minutes we stopped,” recalledWhitworth, “because the operating room was totally quiet,” stunned into silence Oz, Whitworth, and

a group of believers later met secretly to discuss what would eventually become Columbia’sCardiovascular Institute and Complementary Medicine Program “If the higher-ups had known aboutthese meetings,” recalled Whitworth, “they would have disbanded us.”

Oz has used his show to promote alternative therapies ranging from naturopathy, homeopathy,acupuncture, therapeutic touch, faith healing, and chiropractic manipulations to communicating withthe dead To understand where Mehmet Oz is coming from, we need to understand where medicinehas been

People have been living on earth for about 250,000 years For the past 5,000, healers have beentrying to heal the sick For all but the past 200, they haven’t been very good at it

First, people believed disease was a divine act In Exodus, written around 1400 B.C., God, angry

at the Egyptians for their mistreatment of the Hebrews, punishes them with ten plagues, including

boils and lice In Homer’s Iliad, written around 900 B.C., the god Apollo destroys the Achaean army

with a disease ignited by a flaming arrow In 2 Samuel, written around 500 B.C., God gives David achoice of three punishments for his pridefulness: seven years of famine, three months fleeing hisenemies, or three days of plague David chooses plague, and God obliges, killing 77,000 people.Because God or the gods caused disease, healers were shamans, witches, and priests, and treatmentswere prayer, amulets, and sacrifices

Then, starting with the Greek healer Hippocrates in 400 B.C., the focus changed No longer were

diseases defined in supernatural terms; rather, they were caused by something inside the body—

specifically, an imbalance of bodily fluids called humors Hippocrates, the father of medicine, namedthese humors yellow bile, black bile, phlegm, and blood, likening them to four colors (yellow, black,white, and red), four elements (fire, earth, water, and air), four seasons (summer, autumn, winter, andspring), four organs (spleen, gall bladder, lungs, and liver), and four temperaments (choleric,melancholic, phlegmatic, and sanguine) Because diseases were caused by an imbalance of humors,treatments were designed to balance them, most prominently bloodletting, enemas, and emetics (drugsthat induce vomiting) Malaria wasn’t caused by a parasite; it was the result of excess yellow bilefrom hot summer weather Epilepsy wasn’t linked to abnormal brain activity; it was caused by toomuch phlegm blocking the windpipe Cancer wasn’t caused by an uncontrolled growth of cells but bythe accumulation of black bile Inflammation didn’t stem from a vigorous immune response; it wascaused by too much blood (hence bloodletting)

Two hundred years later, in the second century B.C., Chinese healers embraced a similar concept,reasoning that diseases were caused by an imbalance of energies Chinese healers treated thisimbalance by placing a series of thin needles under the skin (acupuncture) However, becauseChinese physicians were prohibited from dissecting human bodies, they didn’t know that nerves

originated in the spinal cord In fact, they didn’t know what nerves were Or what the spinal cordwas Or what the brain was Rather, they interpreted events inside the body based on what they couldsee outside, like rivers and sunsets Chinese physicians believed that energy flowed through a series

of twelve meridians that ran in longitudinal arcs from head to toe, choosing the number twelve

because there are twelve great rivers in China To release vital energy, which they called chi, and restore normal balance between competing energies, which they called yin and yang, needles were

placed under the skin along these meridian lines The number of acupuncture points—about 360—was determined by the number of days in the year Depending on the practitioner, needles wereinserted up to four inches deep and left in place from a few seconds to a few hours

And that’s pretty much the way things stood until the late 1700s Practitioners continued to offertherapies based on religious notions of divine intervention or Greek notions of balancing humors orChinese notions of balancing energies (Some, such as purgatives, acupuncture, aromatherapy, crystalhealing, enemas, magnet therapy, hydrotherapy, and faith healing, are still around today.) But of all thetherapies rooted in ancient beliefs, none was more widespread or universally embraced in theeighteenth century than bloodletting European doctors bled their patients twice a month Barbers, too,were perfectly willing to bleed their customers (The red-and-white barber pole represents a whitebandage wrapped around a bloody arm.) In the United States, Benjamin Rush, a well-respectedPhiladelphia physician and signer of the Declaration of Independence, was a big proponent ofbloodletting Rush was so influential that when George Washington suffered epiglottitis (inflammation

of the flap of tissue that sits on top of the windpipe), his doctors chose bloodletting instead of thetracheotomy that might have saved his life Five pints of blood—about half his total blood volume—were taken from Washington as he struggled to breathe On December 14, 1799, George Washington,

a man who had survived smallpox and bullet wounds, went into shock—killed by bloodletting SirWilliam Osler, cofounder of Johns Hopkins Hospital, in Baltimore, delivered a fitting postscript

“Man knew little more at the end of the eighteenth century,” said Osler, “than the ancient Greeks.”

Then medicine took a giant leap forward Healers no longer believed that illnesses were a matter ofspiritual will or humoral imbalances; rather, they defined diseases in biochemical and biophysicalterms This revolution in medical thought centered on several defining moments:

In 1796, Edward Jenner, a country doctor working in southern England, found he could protectpeople from smallpox by inoculating them with cowpox, a related virus Jenner’s vaccine eliminatedsmallpox—a disease that had killed as many as 500 million people—from the face of the earth Byinducing the immunity that follows natural infection without having to pay the price of naturalinfection, vaccines have dramatically reduced deaths from rabies, diphtheria, tetanus, polio, measles,rubella, hepatitis, chickenpox, rotavirus, influenza, yellow fever, typhoid, and meningitis

In 1854, John Snow, a British physician, investigated an outbreak of cholera in London that hadkilled more than six hundred people Snow traced the problem to a water pump on Broad Street After

he removed the pump handle, the outbreak stopped Snow’s observation launched the field ofepidemiology and lifesaving sanitation programs

In 1876, Robert Koch, a German physician, isolated the bacteria that cause anthrax Knowing thatspecific bacteria caused specific diseases, scientists could now find ways to treat them

In 1928, Alexander Fleming, a Scottish biologist, noticed that a mold (Penicillium notatum)

growing in broth was excreting a substance that killed surrounding bacteria He called it penicillin.Once-fatal diseases were now treatable.

In 1944, Oswald Avery, an American scientist, found that DNA was the substance from whichgenes and chromosomes were made, allowing disorders like sickle-cell anemia and cystic fibrosis to

be defined in genetic terms

But it was a relatively unknown Scottish surgeon who—fifty years before Jenner’s smallpox

vaccine—made the single greatest contribution to medical thought In 1746, James Lind climbed

aboard the HMS Salisbury, determined to find a cure for scurvy, a disease common among sailors

that caused bleeding, anemia, softening of the gums, loss of teeth, kidney failure, seizures, andoccasionally death Lind divided twelve sailors into six groups of two One pair received a quart ofcider every day; the second, twenty-five drops of sulfuric acid three times a day; the third, twospoonfuls of vinegar three times a day; the fourth, a pint of seawater; the fifth, garlic, mustard, radishroot, and myrrh gum; and the sixth, two oranges and a lemon Lind found that only fruits cured scurvy

In 1795, fifty years later, the British Admiralty ordered a daily ration of lime juice for sailors, andscurvy disappeared (British citizens have been called limeys ever since.)

Although Lind had proved that citrus fruits cured scurvy, he didn’t know why It wasn’t until theearly 1900s that a Hungarian biochemist named Albert Szent-Györgyi isolated the substance latercalled vitamin C, or ascorbic acid (literally, “an acid against scurvy”) Lind’s study wasgroundbreaking because it was the first prospective, controlled experiment ever performed, paving

the way for evidence-based medicine No longer did people have to believe in certain therapies; they

could test them

Vaccines, antibiotics, sanitation, purified drinking water, and better hygiene allowed people to livelonger From the beginning to the end of the twentieth century, the life span of Americans hadincreased by thirty years None of this increase occurred because healers balanced humors, restored

chi, or offered sacrifices to the gods; it occurred because we finally understood what caused diseases

and how to treat or prevent them

In a sense, The Dr Oz Show is a voyage back through the history of medicine, starting with our most

primitive concept of what caused disease: supernatural forces

In February 2011, Mehmet Oz asked Dr Issam Nemeh onto his show Nemeh is a faith healer Hebelieves that people can be cured with prayer One of Nemeh’s successes, Cathy, told her story “Iwas so sick,” she recalls “I was coughing up blood I wasn’t breathing well I had a mass in my leftlung.” Oz showed the audience Cathy’s CT scan, which revealed a small, worrisome mass “I went tosee Dr Nemeh,” Cathy continued “And I had a two-hour visit where we talked and we prayedtogether All of a sudden I took this deep breath of air And I just kept taking breaths I couldn’tbelieve how much air I was taking in I felt wonderful.” Just like that, Cathy’s mass was gone Asecond CT scan proved that her lungs were back to normal No chemotherapy No radiation Justprayer A miracle

Unfortunately, Cathy’s story contained several inconsistencies First, Oz never mentioned a biopsy,

suggesting that the diagnosis had been made by CT scan alone This should never happen Becauseinfections can mimic cancer—and because infections are treated differently—a biopsy is required.Second, a closer look at Cathy’s CT scan showed that the mass had ragged edges, more consistentwith inflammation (seen in bacterial infections) than cancer (where edges are typically smooth) In alllikelihood, Cathy had a minor case of bacterial pneumonia that resolved without antibiotics, acommon event Oz’s viewers, however, were left with the notion that prayer alone had cured her.(George Bernard Shaw commented on the limits of faith healing after a visit to the shrine of Lourdes.

“All those canes, braces, and crutches,” he wrote, “and not a single glass eye, wooden leg, ortoupee.”)

Another example of Oz’s embrace of supernatural beliefs can be seen during his surgeries, whichlook like those of any other surgeon with one exception: the presence of reiki masters like PamelaMiles, a practitioner of therapeutic touch whom Oz has featured on his show Miles claims that shecan detect human energy fields and manipulate them to heal the sick Oz has never put Miles’s claims

to the test But it wouldn’t be that hard to do In fact, it was done a few years ago in a study designed,conducted, and analyzed by Emily Rosa

Rosa asked twenty-one therapeutic touch healers to sit behind a large partition with two holes atthe bottom; she couldn’t see them and they couldn’t see her Then she asked the healers to put theirhands, palms up, through the holes After flipping a coin, Rosa put her hand slightly above eachhealer’s right or left hand, asking them to pick which she had chosen If healers could truly detect herenergy field, they would have picked the correct hand 100 percent of the time; if not, about 50 percent

of the time Rosa found that healers were right 44 percent of the time—no different than chance Sheconcluded, “Their failure to substantiate therapeutic touch’s most fundamental claim is unrefutedevidence that [their beliefs] are groundless and that further professional use is unjustified.”

In 1999, Emily Rosa published her paper in the Journal of the American Medical Association It

was titled “A Close Look at Therapeutic Touch.” Unlike Mehmet Oz, Rosa wasn’t a cardiovascularsurgeon In fact, she had never graduated from medical school Or college Or high school Orelementary school When it came time to write her paper, she had asked her mother, a nurse, to help.That’s because Emily was only nine years old Her experiment was part of a fourth-grade science fairproject in Fort Collins, Colorado

Emily didn’t win the science fair “It wasn’t a big deal in my classroom,” recalled Rosa, whograduated from the University of Colorado at Denver in 2009 “I showed it to a few of my teachers,but they really didn’t care, which kind of hurt my feelings.” Emily’s mother, Linda, recalled that

“some of the teachers were getting therapeutic touch during the noon hour They didn’t recommend itfor the district science fair It just wasn’t well received at the school.” The press, however, feltdifferently Emily appeared on the news on ABC, CBS, NBC, and PBS and was featured in specials

by John Stossel, the BBC, Fox, CNN, MSNBC, Nick News, Scientific American Frontiers, the Discovery Channel, NPR’s All Things Considered, the Today show, and I’ve Got a Secret Her story was reported by the Associated Press, United Press International, Reuters, Time, and People magazine and appeared on the front pages of the New York Times and the Los Angeles Times When

she was only eleven years old, Rosa spoke at Harvard University in place of the absent DoloresKrieger, the inventor of therapeutic touch and winner of Harvard’s tongue-in-cheek Ig Nobel Prize for

her claim that human energy fields felt like “warm Jell-O or warm foam.” The next day, Emily gave

her Harvard speech at MIT Emily Rosa is listed in Guinness World Records as the youngest person

to publish a paper in a peer-reviewed medical or scientific journal

Mehmet Oz’s fascination with supernatural forces didn’t end with faith healers and therapeutictouch Later, when he picked John Edward to educate his audience, Oz entered the world of theoccult

Edward is a psychic who communicates with the dead (like the Whoopi Goldberg character in

Ghost, except without the crystal ball and robes) Oz featured Edward on a show titled “Are Psychics

the New Therapists?” “We’ve had more requests [from our viewers] to join this show than any otherwe’ve ever done,” gushed Oz “More than weight loss, more than cancer, more than heart disease.The topic? Do you believe we can talk to the dead?” Oz explained that Edward claimed to havehelped thousands of people communicate with loved ones in the afterlife “A session with a mediumcan be extremely therapeutic,” said Edward

Oz’s interest in the occult came from his experiences in the operating room: “As a heart surgeon,I’ve seen things about life and death that I can’t explain and that science can’t address.” To Mehmet

Oz, John Edward had a gift that was beyond the reach of science “I want you to know that your mom

is okay,” Edward told an audience member “She has a dog with her.”

Although Oz promotes Edward’s powers, James Randi—a stage magician—doesn’t buy it Randi

has appeared on The Tonight Show Starring Johnny Carson as well as Penn & Teller: Bullshit! In

1986, after receiving the MacArthur Foundation “genius” award, Randi decided to use the money toexpose psychics He now offers $1 million to anyone who can demonstrate clear evidence ofparanormal, supernatural, or occult powers Edward has never taken Randi up on his offer

According to James Randi, psychics like John Edward employ two basic strategies: “hot reading,”which uses information obtained from the audience before the show, and “cold reading,” which fishesfor information during the show Randi calls this “hustling the bereaved.” It’s not hard to see throughEdward’s claims When his readings are wrong, Edward claims he has been confused by “energies”emanating from different families When he has enough wrong guesses, he claims that the “energy” ispulling back Oz, who is either remarkably trusting, painfully naive, or simply pandering to a gulliblepublic to enhance advertising revenue, never questioned Edward’s special gift “What happens whenyou start hearing voices,” he enthused

In addition to touting therapies born of the Old Testament notion that supernatural forces causeddisease, Mehmet Oz promotes thousand-year-old natural remedies rooted in ancient Greece, China,and India, featuring two men he calls his “Superstars of Alternative Medicine”: Andrew Weil andDeepak Chopra, both of whom recommend a variety of therapies (such as acupuncture, plants, herbs,oils, and spices) originally designed to balance humors and restore energies

Andrew Weil is a balding, white-bearded, slightly overweight man with the demeanor of a guru Agraduate of Harvard Medical School, Weil did an internship at Mount Zion, in San Francisco—ahospital located next to Haight-Ashbury, the epicenter of the hippie counterculture of the 1960s In the

spirit of Ken Kesey (the subject of Tom Wolfe’s The Electric Kool-Aid Acid Test ), Weil fit right in, choosing to study hallucinogenic drugs In 1972, he published his first book, The Natural Mind, in

which he claimed that hallucinogens can “unlock” the brain and—in a chapter titled “A Trip toStonesville”—that “stoned” thinking makes people more insightful He even celebrated psychosis

“Every psychotic is a potential sage or healer,” he wrote “I am almost tempted to call psychotics theevolutionary vanguard of our species.”

After completing one year of a two-year program at the National Institutes of Health, Weil

continued to promote his belief that hallucinogenic drugs are good for you In 1983, he wrote From

Chocolate to Morphine: Everything You Need to Know About Mind-Altering Drugs Weil even has

a hallucinogenic mushroom, Psilocybe weilii, named after him But Weil’s apotheosis came in 1995 with the publication of Spontaneous Healing, in which he claimed that health and illness are

“manifestations of good and evil, requiring the help of religion and philosophy to understand and allthe techniques of magic to manipulate.” The public ate it up Weil lectured to packed audiences and

appeared frequently on Oprah and Larry King Live His books became international best sellers, and his face appeared on the cover of Time—twice Publishers Weekly described Weil as “America’s best-known complementary care physician,” the San Francisco Chronicle as “the guru of alternative medicine,” Time as “Mr Natural,” and his own books as “America’s most trusted medical expert.”

Andrew Weil is one of America’s most famous, most influential alternative healers

Another of Mehmet Oz’s “Superstars” is Deepak Chopra Chopra was born and raised in NewDelhi, where he attended the All India Institute of Medical Sciences, and later moved to the UnitedStates to complete residencies in internal medicine and endocrinology As chief of staff at NewEngland Memorial Hospital, Chopra “noticed a growing lack of fulfillment.” He asked himself, “Am Idoing all I can for my patients?” So he visited onetime Beatles guru Maharishi Mahesh Yogi, whopersuaded Chopra to found the American Association of Ayurvedic Medicine and become thedirector of the Maharishi Ayurveda Health Center Ayurvedic medicine, founded in India twothousand years ago, is based on the ancient Greek notion of balancing humors However, unlike

Hippocrates’s four humors, ayurvedic medicine balances three humors, or doshas: wind (vata), choler (pitta), and phlegm (kapha) To determine whether doshas are out of balance, healers take a

patient’s pulse

Chopra became a national guru on Monday, July 12, 1993, when he appeared on The Oprah

Winfrey Show to promote his book Ageless Body, Timeless Mind Within twenty-four hours he had

sold 137,000 copies; by the end of the week it was 400,000

In addition to Old Testament and ancient Greek, Chinese, and Indian remedies, Oz also promotes therelatively modern concepts of homeopathy and chiropractic manipulations, both of which represent akind of devolution in medical thinking

Homeopathy was the creation of Samuel Hahnemann, who practiced in Germany and Francebetween 1779 and 1843 Hahnemann was disturbed by the brutality of nineteenth-century medicine,which included bloodletting with leeches, poison-induced vomiting, and skin blistering with acids

He wanted a safer, better way to treat people His epiphany came in 1790 While ingesting powderfrom the bark of a cinchona tree, Hahnemann developed a fever At the time, it was known thatcinchona bark, which contained quinine, could treat malaria Hahnemann believed that because he had

fever, and because fever was a symptom of malaria, medicines should induce the same symptoms asthe disease For example, vomiting illnesses should be treated with medicines that cause vomiting.(Homeopathy literally means “similar suffering.”) To be on the safe side, Hahnemann also believedthat homeopathic medicines should be diluted to the point that they aren’t there anymore Although theactive ingredient was gone, Hahnemann believed, the final preparation would be influenced by themedicines having once been there.

Like homeopathy, chiropractic manipulations are also the brainchild of one man: Daniel D Palmer.Palmer was a mesmerist who used magnets to treat his patients But in 1895, when a man who hadbeen deaf for seventeen years walked into his office, Palmer tried something else Believing thatdeafness was caused by a misaligned spinal column, which he called “subluxation,” Palmer pusheddown on the back of the man’s neck, hoping to realign his spine It worked; the man recovered hishearing immediately (The event is often referred to as “the crack heard round the world.”) Mostmiraculous about Palmer’s cure is that the eighth cranial nerve, which conducts nerve impulses fromthe ear to the brain, doesn’t travel through the neck Palmer then took the next illogical step, arguing

that all diseases were caused by misaligned spines Because this isn’t true, it shouldn’t be surprising

that studies have shown that chiropractic manipulations don’t treat many of the diseases they areclaimed to, such as headaches, menstrual pain, colic, asthma, and allergies

Although Oz promotes therapies born before scientists had determined what caused diseases andwhy, he’s enormously popular—for many reasons

First, Oz and his Superstars provide an instruction book for something that doesn’t come withinstructions: life Collectively, books written by Oz, Weil, and Chopra tell people exactly what to eatand when to eat it; how to be a friend; how to sustain a loving relationship; how and when toexercise; which shampoos, cleaning fluids, laundry detergents, and baby foods to use; how to preparemeals (including “Dr Weil’s Favorite Low-Fat Salad Dressing”); and how to treat almost everypossible illness It’s reassuring to know that there’s a right and wrong way to do everything Andbecause these books are so definitive, so clear about how to handle almost any disease, they inspire acultlike devotion among their followers Do it our way and you’ll live longer, love better, and raisehappier, healthier children Given life’s arbitrary, capricious, and unpredictable nature, these bookscan be quite comforting

Another lure of alternative medicine is that it’s personalized Practitioners of modern medicine canappear callous and insensitive Patients feel more like a number than a person That’s wherealternative healers come in: they provide individual care, because they care “Doctors are trapped inthis system,” says Andrew Weil “A ravenously for-profit system.” But Weil isn’t trapped: “I listen tothem,” he says “I take sixty minutes on a first visit.” “My advice for everybody,” says Mehmet Oz,

“is to customize therapy for yourself.”

The promise of ancient wisdom is also appealing When Mehmet Oz discussed acupuncture on The

Dr Oz Show, he made a rather surprising statement “It’s the basis of ancient Chinese medicine,” he

insisted Oz was arguing that we should trust ancient medicine because it’s ancient Today’s culture

is filled with this sentiment For example, in the movie 2012, starring John Cusack and Amanda Peet,

the world is coming to an end—something that apparently had been predicted by the Mayan calendar

“All our scientific advances,” laments one scientist, “all our fancy machines—the Mayans saw this

coming thousands of years ago.” The writers of 2012 knew their audience Many people believe that

ancient healers and soothsayers, free from confusing modern technologies, possessed a clearer, wiserview of things “One of the arguments mobilized by alternative medicine practitioners againstorthodox medicine is that the latter is constantly changing while alternative medicine has remained

unaltered for hundreds, even thousands of years,” wrote Raymond Tallis in Hippocratic Oaths:

Medicine and Its Discontents “The lack of development in 5,000 years can be a good thing only if

5,000 years ago alternative practitioners already knew of entirely satisfactory treatments If they did,they have been remarkably quiet about them.” Modern medicine is carved by centuries of learning Itcontinues to evolve because it continues to generate new information It isn’t fixed in time But thefluidity of modern medicine can be unsettling Alternative medicine’s certainty, on the other hand, can

be quite reassuring

Ironically, while alternative remedies are embraced in the developed world, they’re often rejected

in the countries where they originated In mainland China, for example, where both traditional andmodern therapies are available, only 18 percent of the population relies on alternative medicines; inHong Kong, 14 percent; and in Japan, even less In China, acupuncture is embraced almost solely bythe rural poor “It’s easy for the well-fed metropolitan with time and money on his hands to talk aboutdealing with chronic symptoms with ayurvedic medicine or Chinese herbal therapies or ancient

African or Native American remedies,” writes John Diamond in Snake Oil and Other

Preoccupations “But if you go to the countries where those remedies are all they have, you’ll find

them crying out for good old Western antibiotics, painkillers, and all the rest of the modern andexpensive pharmacopoeia When the government of South Africa complains that not enough is beingdone to help the 10 percent of its population which is HIV-positive, it isn’t asking for help withpreparing ‘natural’ remedies: it wants AZT.”

Traditional healers also offer something else Where modern medicine is spiritless andtechnological, they argue, alternative medicine is spiritual and meaningful “The more the universeseems comprehensible,” wrote Steven Weinberg, a Nobel Prize–winning physicist, “the more itseems pointless.” Although modern science offers the prospect of longer lives, it doesn’t offer theprospect of more meaningful lives Alternative medicine, on the other hand, offers something greater:better health imbued with a deeper sense of purpose Oz, Weil, and Chopra proffer their remedieswith a spirituality that borders on mysticism “Nothing is more dangerous than science without poetry

or technical progress without emotional content,” wrote Houston Stewart Chamberlain, a Germanphilosopher In a culture that doesn’t understand technology, and is often frightened and disappointed

by it, spiritualism is an easy sell

Finally, practitioners of alternative medicine appeal to the popular notion that you can manage yourown health, that you don’t need doctors to tell you what to do “Alternative medicine is at the grassroots level,” says Oz “And because of that, nobody owns it Alternative medicine empowers us And

if it does work for you, don’t let anybody take it away.” The offer of control in a health-care systemwhere patients feel little or no control is irresistible “The lure of alternative therapies won’t end,”

says Harriet Hall, a former flight surgeon and a regular contributor to Skeptical Inquirer magazine,

“until you take the ‘human’ out of human nature.”

At the heart of our distrust of modern medicine is the notion that we’ve rejected nature at our own

peril—that big pharmaceutical companies, by synthesizing products in laboratories, have led us awayfrom the natural products that allow us to live longer And what could be more natural than vitamins.

Part II

THE LURE OF ALL THINGS

NATURAL

The Vitamin Craze:

Linus Pauling’s Ironic Legacy

I gotta tell you, right at the top of my list would be taking vitamins I know that over the years doctors have said they’re ridiculous and all that But I started taking my vitamins at an early age And I take them every day Every bloody day! So I think that’s number one For whatever reason, I feel active and pretty good at my age.

—Regis Philbin

Everyone loves vitamins Derived from the Latin word vita, meaning “life,” vitamins are necessary

for the conversion of food into energy Millions of Americans believe that taking daily vitaminsmakes them feel better and live longer

Thirteen vitamins have been identified Nine are easily dissolved in water: vitamins B1 (thiamine),

B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B9 (folic acid), B12(cobalamin), and C (ascorbic acid) Four aren’t water-soluble: vitamins A (retinol), D (calciferol), E(tocopherol), and K (phylloquinone) When people don’t get enough vitamins, they suffer diseasessuch as beriberi, pellagra, scurvy, and rickets (caused by deficiencies of vitamins B1, B3, C, and D,respectively)

The problem with most vitamins is that they aren’t made inside the body; they’re available only infoods or supplements So the question isn’t “Do people need vitamins?” They do The real questionsare “How much do they need?” and “Do they get enough in foods?” Nutrition experts and vitaminmanufacturers are split on the answers to these questions Nutrition experts argue that all people need

is the recommended daily allowance (RDA), typically found in a routine diet Industryrepresentatives argue that foods don’t contain enough vitamins and that larger quantities are needed.Fortunately, many excellent studies have now resolved the issue

On October 10, 2011, researchers from the University of Minnesota found that women who tooksupplemental multivitamins died at rates higher than those who didn’t Two days later, researchers

from the Cleveland Clinic found that men who took vitamin E had an increased risk of prostatecancer “It’s been a tough week for vitamins,” said Carrie Gann of ABC News.

These findings weren’t new Seven previous studies had already shown that vitamins increased therisk of cancer and heart disease and shortened lives Still, in 2012, more than half of all Americanstook some form of vitamin supplements What few people realize, however, is that their fascinationwith vitamins can be traced back to one man A man who was so spectacularly right that he won twoNobel Prizes and so spectacularly wrong that he was arguably the world’s greatest quack

Linus Pauling was born on February 28, 1901, in Portland, Oregon He attended OregonAgricultural College (now Oregon State University), in Corvallis, before entering the CaliforniaInstitute of Technology (Caltech), where he taught for more than forty years

In 1931, Pauling published a paper in the Journal of the American Chemical Society titled “The

Nature of the Chemical Bond.” Before publication, chemists knew of two types of chemical bonds:ionic, where one atom gives up an electron to another; and covalent, where atoms share electrons.Pauling argued that it wasn’t that simple—electron sharing was somewhere between ionic andcovalent Pauling’s idea revolutionized the field, marrying quantum physics with chemistry Hisconcept was so revolutionary that when the journal editor received the manuscript, he couldn’t findanyone qualified to review it When Albert Einstein was asked what he thought of Pauling’s work, heshrugged his shoulders “It was too complicated for me,” he said For this single paper, Paulingreceived the Langmuir Prize as the most outstanding young chemist in the United States, became theyoungest person elected to the National Academy of Sciences, was made a full professor at Caltech,and won the Nobel Prize in Chemistry He was thirty years old

In 1949, Pauling published a paper in Science titled “Sickle Cell Anemia, a Molecular Disease.”

At the time, scientists knew that hemoglobin (the protein in blood that transports oxygen) crystallized

in the veins of people with sickle-cell anemia, causing joint pain, blood clots, and death But theydidn’t know why Pauling was the first to show that sickle hemoglobin had a slightly differentelectrical charge—a quality that dramatically affected how the hemoglobin reacted with oxygen Hisfinding gave birth to the field of molecular biology

In 1951, Pauling published a paper in the Proceedings of the National Academy of Sciences titled

“The Structure of Proteins.” Scientists knew that proteins were composed of a series of amino acids.Pauling proposed that proteins also had a secondary structure determined by how they folded uponthemselves He called one configuration the alpha helix—later used by James Watson and FrancisCrick to explain the structure of DNA

In 1961, Pauling collected blood from gorillas, chimpanzees, and monkeys at the San Diego Zoo

He wanted to see whether mutations in hemoglobin could be used as a kind of evolutionary clock.Pauling showed that humans had diverged from gorillas about 11 million years ago, much earlier thanscientists had suspected A colleague later remarked, “At one stroke he united the fields ofpaleontology, evolutionary biology, and molecular biology.”

Pauling’s accomplishments weren’t limited to science Beginning in the 1950s—and for the nextforty years—he was the world’s most recognized peace activist Pauling opposed the internment ofJapanese Americans during World War II, declined Robert Oppenheimer’s offer to work on theManhattan Project, stood up to Senator Joseph McCarthy by refusing a loyalty oath, opposed nuclear

proliferation, publicly debated nuclear-arms hawks like Edward Teller, forced the government toadmit that nuclear explosions could damage human genes, convinced other Nobel Prize winners to

oppose the Vietnam War, and wrote the best-selling book No More War! Pauling’s efforts led to the

Nuclear Test Ban Treaty In 1962, he won the Nobel Peace Prize—the first person ever to win twounshared Nobel Prizes

In addition to his election to the National Academy of Sciences, two Nobel Prizes, the NationalMedal of Science, and the Medal for Merit (which was awarded by the president of the UnitedStates), Pauling received honorary degrees from Cambridge University, the University of London, and

the University of Paris In 1961, he appeared on the cover of Time magazine’s Men of the Year issue,

hailed as one of the greatest scientists who had ever lived

Then all the rigor, hard work, and hard thinking that had made Linus Pauling a legend disappeared

In the words of a colleague, his “fall was as great as any classic tragedy.”

The turning point came in March 1966, when Pauling was sixty-five years old He had justreceived the Carl Neuberg Medal “During a talk in New York City,” recalled Pauling, “I mentionedhow much pleasure I took in reading about the discoveries made by scientists in their variousinvestigations of the nature of the world, and stated that I hoped I could live another twenty-five years

in order to continue to have this pleasure On my return to California I received a letter from abiochemist, Irwin Stone, who had been at the talk He wrote that if I followed his recommendation oftaking 3,000 milligrams of vitamin C, I would live not only twenty-five years longer, but probablymore.” Stone, who referred to himself as Dr Stone, had spent two years studying chemistry incollege Later, he received an honorary degree from the Los Angeles College of Chiropractic and a

“PhD” from Donsbach University, a non-accredited correspondence school in Southern California.Pauling followed Stone’s advice “I began to feel livelier and healthier,” he said “In particular,the severe colds I had suffered several times a year all my life no longer occurred After a few years,

I increased my intake of vitamin C to ten times, then twenty times, and then three hundred times theRDA: now 18,000 milligrams per day.”

From that day forward, people would remember Linus Pauling for one thing: vitamin C

In 1970, Pauling published Vitamin C and the Common Cold, urging the public to take 3,000

milligrams of vitamin C every day (about fifty times the RDA) Pauling believed that the commoncold would soon be a historical footnote “It will take decades to eradicate the common coldcompletely,” he wrote, “but it can, I believe, be controlled entirely in the United States and someother countries within a few years I look forward to witnessing this step toward a better world.”Pauling’s book became an instant best seller Paperback versions were printed in 1971 and 1973, and

an expanded edition titled Vitamin C, the Common Cold and the Flu, published three years later,

promised to ward off a predicted swine flu pandemic Sales of vitamin C doubled, tripled, andquadrupled Drugstores couldn’t keep up with demand By the mid-1970s, 50 million Americanswere following Pauling’s advice Vitamin manufacturers called it “the Linus Pauling effect.”

Scientists weren’t as enthusiastic On December 14, 1942, about thirty years before Pauling

published his first book, Donald Cowan, Harold Diehl, and Abe Baker, from the University of

Minnesota, published a paper in the Journal of the American Medical Association titled “Vitamins

for the Prevention of Colds.” The authors concluded, “Under the conditions of this controlled study,

in which 980 colds were treated there is no indication that vitamin C alone, an antihistaminealone, or vitamin C plus an antihistamine have any important effect on the duration or severity ofinfections of the upper respiratory tract.”

Other studies followed After Pauling’s pronouncement, researchers at the University of Marylandgave 3,000 milligrams of vitamin C every day for three weeks to eleven volunteers and a sugar pill(placebo) to ten others Then they infected volunteers with a common cold virus All developed coldsymptoms of similar duration At the University of Toronto, researchers administered vitamin C orplacebo to 3,500 volunteers Again, vitamin C didn’t prevent colds, even in those receiving as much

as 2,000 milligrams a day In 2002, researchers in the Netherlands administered multivitamins orplacebo to more than 600 volunteers Again, no difference At least fifteen studies have now shownthat vitamin C doesn’t treat the common cold As a consequence, neither the FDA, the AmericanAcademy of Pediatrics, the American Medical Association, the American Dietetic Association, theCenter for Human Nutrition at the Johns Hopkins Bloomberg School of Public Health, nor theDepartment of Health and Human Services recommend supplemental vitamin C for the prevention ortreatment of colds

Although study after study showed that he was wrong, Pauling refused to believe it, continuing topromote vitamin C in speeches, popular articles, and books When he occasionally appeared beforethe media with obvious cold symptoms, he said he was suffering from allergies

Then Linus Pauling upped the ante He claimed that vitamin C not only prevented colds; it curedcancer

In 1971, Pauling received a letter from Ewan Cameron, a Scottish surgeon from a tiny hospitaloutside Glasgow Cameron wrote that cancer patients who were treated with ten grams of vitamin Cevery day had fared better than those who weren’t Pauling was ecstatic He decided to publish

Cameron’s findings in the Proceedings of the National Academy of Sciences (PNAS) Pauling assumed that as a member of the academy he could publish a paper in PNAS whenever he wanted;

only three papers submitted by academy members had been rejected in more than half a century.Pauling’s paper was rejected anyway, further tarnishing his reputation among scientists Later, the

paper was published in Oncology, a journal for cancer specialists When researchers evaluated the

data, the flaw became obvious: the cancer victims Cameron had treated with vitamin C were healthier

at the start of therapy, so their outcomes were better After that, scientists no longer took Pauling’sclaims about vitamins seriously

But Linus Pauling still had clout with the media In 1971, he declared that vitamin C would cause a

10 percent decrease in deaths from cancer In 1977, he went even further “My present estimate is that

a decrease of 75 percent can be achieved with vitamin C alone,” he wrote, “and a further decrease byuse of other nutritional supplements.” With cancer in their rearview mirror, Pauling predicted,Americans would live longer, healthier lives “Life expectancy will be 100 to 110 years,” he said,

“and in the course of time, the maximum age might be 150 years.”

Cancer victims now had reason for hope Wanting to participate in the Pauling miracle, they urged

their doctors to give them massive doses of vitamin C “For about seven or eight years, we weregetting a lot of requests from our families to use high-dose vitamin C,” recalls John Maris, chief ofoncology and director of the Center for Childhood Cancer Research at the Children’s Hospital ofPhiladelphia “We struggled with that They would say, ‘Doctor, do you have a Nobel Prize?’ ”

Blindsided, cancer researchers decided to test Pauling’s theory Charles Moertel, of the MayoClinic, evaluated 150 cancer victims: half received ten grams of vitamin C a day and half didn’t Thevitamin C–treated group showed no difference in symptoms or mortality Moertel concluded, “Wewere unable to show a therapeutic benefit of high-dose vitamin C.” Pauling was outraged He wrote

an angry letter to the New England Journal of Medicine, which had published the study, claiming that

Moertel had missed the point Of course vitamin C hadn’t worked: Moertel had treated patients whohad already received chemotherapy Pauling claimed that vitamin C worked only if cancer victimshad received no prior chemotherapy

Bullied, Moertel performed a second study; the results were the same Moertel concluded, “Amongpatients with measurable disease, none had objective improvement It can be concluded that high-dose vitamin C therapy is not effective against advanced malignant disease regardless of whether thepatient had received any prior chemotherapy.” For most doctors, this was the end of it But not forLinus Pauling He was simply not to be contradicted Cameron observed, “I have never seen him soupset He regards the whole affair as a personal attack on his integrity.” Pauling thought Moertel’sstudy was a case of “fraud and deliberate misrepresentation.” He consulted lawyers about suingMoertel, but they talked him out of it

Subsequent studies have consistently shown that vitamin C doesn’t treat cancer

Pauling wasn’t finished Next, he claimed that vitamin C, when taken with massive doses of vitamin

A (25,000 international units) and vitamin E (400 to 1,600 IU), as well as selenium (a basic element)and beta-carotene (a precursor to vitamin A), could do more than just prevent colds and treat cancer;they could treat virtually every disease known to man Pauling claimed that vitamins and supplementscould cure heart disease, mental illness, pneumonia, hepatitis, polio, tuberculosis, measles, mumps,chickenpox, meningitis, shingles, fever blisters, cold sores, canker sores, warts, aging, allergies,asthma, arthritis, diabetes, retinal detachment, strokes, ulcers, shock, typhoid fever, tetanus,dysentery, whooping cough, leprosy, hay fever, burns, fractures, wounds, heat prostration, altitudesickness, radiation poisoning, glaucoma, kidney failure, influenza, bladder ailments, stress, rabies,and snakebites When the AIDS virus entered the United States in the 1970s, Pauling claimed vitaminscould treat that, too

On April 6, 1992, the cover of Time—rimmed with colorful pills and capsules—declared, “The

Real Power of Vitamins: New research shows they may help fight cancer, heart disease, and theravages of aging.” The article, written by Anastasia Toufexis, echoed Pauling’s ill-founded,disproved notions about the wonders of megavitamins “More and more scientists are starting tosuspect that traditional medical views of vitamins and minerals have been too limited,” wroteToufexis “Vitamins—often in doses much higher than those usually recommended—may protectagainst a host of ills ranging from birth defects and cataracts to heart disease and cancer Even moreprovocative are glimmerings that vitamins can stave off the normal ravages of aging.” Toufexisenthused that the “pharmaceutical giant Hoffman-La Roche is so enamored with beta-carotene that it

plans to open a Freeport, Texas, plant next year that will churn out 350 tons of the nutrient annually,

or enough to supply a daily 6 milligram capsule to virtually every American adult.”

The National Nutritional Foods Association (NNFA), a lobbying group for vitamin manufacturers,

couldn’t believe its good luck, calling the Time article “a watershed event for the industry.” As part

of an effort to get the FDA off their backs, the NNFA distributed multiple copies of the magazine toevery member of Congress Speaking at an NNFA trade show later in 1992, Toufexis said, “In fifteen

years at Time I have written many health covers But I have never seen anything like the response to

the vitamin cover It whipped off the sales racks, and we were inundated with requests for copies.There are no more copies ‘Vitamins’ is the number-one-selling issue so far this year.”

Although studies had failed to support him, Pauling believed that vitamins and supplements had oneproperty that made them cure-alls, a property that continues to be hawked on everything from ketchup

to pomegranate juice and that rivals words like natural and organic for sales impact: antioxidant.

Antioxidation vs oxidation has been billed as a contest between good and evil The battle takesplace in cellular organelles called mitochondria, where the body converts food to energy, a processthat requires oxygen and so is called oxidation One consequence of oxidation is the generation ofelectron scavengers called free radicals (evil) Free radicals can damage DNA, cell membranes, andthe lining of arteries; not surprisingly, they’ve been linked to aging, cancer, and heart disease Toneutralize free radicals, the body makes its own antioxidants (good) Antioxidants can also be found

in fruits and vegetables—specifically, selenium, beta-carotene, and vitamins A, C, and E Studieshave shown that people who eat more fruits and vegetables have a lower incidence of cancer andheart disease and live longer The logic is obvious: if fruits and vegetables contain antioxidants—andpeople who eat lots of fruits and vegetables are healthier—then people who take supplementalantioxidants should also be healthier

In fact, they’re less healthy

In 1994, the National Cancer Institute, in collaboration with Finland’s National Public HealthInstitute, studied 29,000 Finnish men, all long-term smokers more than fifty years old This group waschosen because they were at high risk for cancer and heart disease Subjects were given vitamin E,beta-carotene, both, or neither The results were clear: those taking vitamins and supplements were

more likely to die from lung cancer or heart disease than those who didn’t take them—the opposite of

what researchers had anticipated

In 1996, investigators from the Fred Hutchinson Cancer Research Center, in Seattle, studied 18,000people who, because they had been exposed to asbestos, were at increased risk of lung cancer Again,subjects received vitamin A, beta-carotene, both, or neither Investigators ended the study abruptlywhen they realized that those who took vitamins and supplements were dying from cancer and heartdisease at rates 28 and 17 percent higher, respectively, than those who didn’t

In 2004, researchers from the University of Copenhagen reviewed fourteen randomized trialsinvolving more than 170,000 people who took vitamins A, C, E, and beta-carotene to see whetherantioxidants could prevent intestinal cancers Again, antioxidants didn’t live up to the hype Theauthors concluded, “We could not find evidence that antioxidant supplements can prevent

gastrointestinal cancers; on the contrary, they seem to increase overall mortality.” When these same

researchers evaluated the seven best studies, they found that death rates were 6 percent higher in

those taking vitamins.

In 2005, researchers from Johns Hopkins School of Medicine evaluated nineteen studies involvingmore than 136,000 people and found an increased risk of death associated with supplemental vitamin

E Dr Benjamin Caballero, director of the Center for Human Nutrition at the Johns HopkinsBloomberg School of Public Health, said, “This reaffirms what others have said The evidence forsupplementing with any vitamin, particularly vitamin E, is just not there This idea that people havethat [vitamins] will not hurt them may not be that simple.” That same year, a study published in the

Journal of the American Medical Association evaluated more than 9,000 people who took high-dose

vitamin E to prevent cancer; those who took vitamin E were more likely to develop heart failure than

those who didn’t

In 2007, researchers from the National Cancer Institute examined 11,000 men who did or didn’ttake multivitamins Those who took multivitamins were twice as likely to die from advanced prostatecancer

In 2008, a review of all existing studies involving more than 230,000 people who did or did notreceive supplemental antioxidants found that vitamins increased the risk of cancer and heart disease

On October 10, 2011, researchers from the University of Minnesota evaluated 39,000 older womenand found that those who took supplemental multivitamins, magnesium, zinc, copper, and iron died atrates higher than those who didn’t They concluded, “Based on existing evidence, we see littlejustification for the general and widespread use of dietary supplements.”

Two days later, on October 12, researchers from the Cleveland Clinic published the results of astudy of 36,000 men who took vitamin E, selenium, both, or neither They found that those receivingvitamin E had a 17 percent greater risk of prostate cancer In response to the study, Steven Nissen,chairman of cardiology at the Cleveland Clinic, said, “The concept of multivitamins was sold toAmericans by an eager nutraceutical industry to generate profits There was never any scientific data

supporting their usage.” On October 25, a headline in the Wall Street Journal asked, “Is This the End

of Popping Vitamins?”

Studies haven’t hurt sales In 2010, the vitamin industry grossed $28 billion, up 4.4 percent fromthe year before “The thing to do with [these reports] is just ride them out,” said Joseph Fortunato,chief executive of General Nutrition Centers “We see no impact on our business.”

How could this be? Given that free radicals clearly damage cells—and given that people who eatdiets rich in substances that neutralize free radicals are healthier—why did studies of supplementalantioxidants show they were harmful? The most likely explanation is that free radicals aren’t as evil

as advertised Although it’s clear that free radicals can damage DNA and disrupt cell membranes,that’s not always a bad thing People need free radicals to kill bacteria and eliminate new cancercells But when people take large doses of antioxidants, the balance between free radical productionand destruction might tip too much in one direction, causing an unnatural state in which the immunesystem is less able to kill harmful invaders Researchers have called this “the antioxidant paradox.”Whatever the reason, the data are clear: high doses of vitamins and supplements increase the risk ofheart disease and cancer; for this reason, not a single national or international organizationresponsible for the public’s health recommends them

In May 1980, during an interview at Oregon State University, Linus Pauling was asked, “Doesvitamin C have any side effects on long-term use of, let’s say, gram quantities?” Pauling’s answerwas quick and decisive “No,” he replied Seven months later, his wife was dead of stomach cancer.

In 1994, Linus Pauling died of prostate cancer

Despite a wealth of scientific evidence, most Americans don’t know that megavitamins are unsafe

So why don’t more people know about this? And why hasn’t the FDA sounded an alarm? The answer

is predictable: money and politics

Part III

LITTLE SUPPLEMENT MAKERS

VERSUS BIG PHARMA

The Supplement Industry Gets a Free Pass:

Neutering the FDA

Liberty for the wolves is death for the lambs.

—Isaiah Berlin

Government oversight of the pharmaceutical industry has been a long, tortuous journey filled withunimaginable tragedies “The story of drug regulation,” wrote historian Michael Harris, “is built ontombstones.”

It started with purveyors of patent medicines

“How much is your health worth, ladies and gentlemen? It’s priceless, isn’t it? Well, my friends,one half-dollar is all it takes to put you in the pink That’s right, ladies and gents For fifty pennies,Nature’s True Remedy will succeed where doctors have failed Only Nature can heal and I haveNature right here in this little bottle My secret formula, from God’s own laboratory, the Earth itself,will cure rheumatism, cancer, diabetes, baldness, bad breath, and curvature of the spine.”

In the 1800s, medical hucksters could claim anything Boston Drug cured drunkenness Pond’sExtract treated meningitis Hydrozone prevented yellow fever Peruna calmed inflammation of theovaries Liquozone cured asthma, bronchitis, cancer, dysentery, eczema, gallstones, hay fever,malaria, and tuberculosis And Dr Williams’ Pink Pills for Pale People treated all that and more.Sales were limited only by what customers were willing to believe By the turn of the century, patentmedicines were a $75-million-a-year business It didn’t last On June 30, 1906, the federalgovernment stepped in, passing the Pure Food and Drug Act Three men led the charge; one wasconcerned about foods, another about drugs, the third about neither